,Pharmacology BSN 315 Hesi V2 Set 1 and 2
1. The nurse is caring for a client who has taken atenolol for 2 years. The healthcare
provider recently changed the medication to enalapril to manage the client's blood
pressure. The nurse is providing discharge teaching about the newly prescribed
medication and wants to help the client understand potential effects when
beginning therapy. Which instruction should the nurse provide the client regarding
the new medication?
Correct answer: Rise slowly when getting out of the bed or chair.
Enalapril can cause orthostatic hypotension, particularly when therapy is initiated or
the dose is changed. Rising slowly from a lying or sitting position allows the
cardiovascular system time to adjust to the change in blood pressure and reduces the
risk of dizziness and falls. The client should sit at the bedside briefly before standing
and should report persistent dizziness or fainting to the healthcare provider.
2. A female client calls the clinic after taking amoxicillin for 5 days to treat a
bacterial infection. She reports new vaginal discomfort accompanied by itching and
a thick white vaginal discharge. The nurse recognizes that these findings may occur
because antibiotic therapy can alter the normal vaginal flora. Which action should
the nurse discuss with the client?
Correct answer: Consult with a healthcare provider about another treatment
for this effect.
Amoxicillin can disrupt normal protective vaginal flora and promote the overgrowth
of Candida, resulting in symptoms consistent with vulvovaginal candidiasis. The client
should contact the healthcare provider for evaluation and appropriate antifungal
treatment rather than stopping the antibiotic independently. Prompt treatment can
relieve the symptoms and prevent worsening discomfort.
,3. NGN—The nurse is making rounds on a group of clients when one client
suddenly begins exhibiting symptoms of an acute asthma attack, including
wheezing and difficulty breathing. The nurse administers a prescribed PRN short-
acting beta-2 receptor agonist to provide rapid bronchodilation. Which client
responses should the nurse expect after administration? SATA
Correct answers: Rapid resolution of wheezing; Improved pulse oximetry
values.
Short-acting beta-2 agonists produce rapid relaxation of bronchial smooth muscle,
which improves airflow and decreases bronchospasm. As airway obstruction
improves, wheezing should decrease and oxygenation should improve, resulting in
better pulse oximetry readings. The nurse should continue to assess respiratory rate,
breath sounds, oxygen saturation, and the client's overall work of breathing.
4. A client prescribed atenolol has a blood pressure of 120/68 mmHg, sinus
bradycardia with a heart rate of 58 beats/minute, and a PR interval of 0.24
seconds. The client is being assessed before the scheduled dose, and the nurse
reviews the cardiac rhythm and vital signs before administering the medication.
Which action should the nurse take?
Correct answer: Give the medication as prescribed and continue to monitor
the client.
Atenolol is a beta-adrenergic blocker that decreases heart rate and blood pressure,
so mild bradycardia can occur during therapy. The client's blood pressure is within an
acceptable range, and the prescribed medication should be administered while the
nurse continues to monitor the heart rate, rhythm, blood pressure, and clinical
status. Any worsening bradycardia, symptomatic hypotension, or significant
conduction changes should be reported promptly.
, 5. The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II
receptor blocker, for a client with hypertension and heart failure. Before
administering the medication, the nurse reviews the client's laboratory results and
notes a serum potassium level of 5.9 mEq/L. Which action should the nurse take
first?
Correct answer: Withhold the scheduled dose.
Losartan can decrease aldosterone activity and reduce potassium excretion, which
can contribute to hyperkalemia. A potassium level of 5.9 mEq/L is significantly
elevated and places the client at risk for potentially serious cardiac dysrhythmias. The
nurse should withhold the scheduled dose and notify the healthcare provider so that
the elevated potassium level and medication regimen can be evaluated.
6. NGN—A client with acute status asthmaticus is prescribed a series of
medications to address bronchospasm, inflammation, and the underlying clinical
condition. The prescriptions include salmeterol (Serevent Diskus), albuterol
(Proventil) puffs, gentamicin (Garamycin) IM, and prednisone (Deltasone) orally.
The nurse must prioritize the medications according to the sequence provided in
the treatment plan. In which order should the nurse administer these medications?
Correct answer: 1) Albuterol (Proventil) → 2) Salmeterol (Serevent Diskus) → 3)
Prednisone (Deltasone) orally → 4) Gentamicin (Garamycin) IM.
Albuterol is administered first because it is a short-acting beta-2 agonist that
produces rapid bronchodilation and is used for acute bronchospasm. Prednisone
provides systemic anti-inflammatory effects that help decrease airway inflammation,
while gentamicin is administered when treatment of a susceptible bacterial infection
is indicated. The sequence prioritizes rapid improvement of bronchospasm before
therapies directed toward inflammation or an infectious cause.
1. The nurse is caring for a client who has taken atenolol for 2 years. The healthcare
provider recently changed the medication to enalapril to manage the client's blood
pressure. The nurse is providing discharge teaching about the newly prescribed
medication and wants to help the client understand potential effects when
beginning therapy. Which instruction should the nurse provide the client regarding
the new medication?
Correct answer: Rise slowly when getting out of the bed or chair.
Enalapril can cause orthostatic hypotension, particularly when therapy is initiated or
the dose is changed. Rising slowly from a lying or sitting position allows the
cardiovascular system time to adjust to the change in blood pressure and reduces the
risk of dizziness and falls. The client should sit at the bedside briefly before standing
and should report persistent dizziness or fainting to the healthcare provider.
2. A female client calls the clinic after taking amoxicillin for 5 days to treat a
bacterial infection. She reports new vaginal discomfort accompanied by itching and
a thick white vaginal discharge. The nurse recognizes that these findings may occur
because antibiotic therapy can alter the normal vaginal flora. Which action should
the nurse discuss with the client?
Correct answer: Consult with a healthcare provider about another treatment
for this effect.
Amoxicillin can disrupt normal protective vaginal flora and promote the overgrowth
of Candida, resulting in symptoms consistent with vulvovaginal candidiasis. The client
should contact the healthcare provider for evaluation and appropriate antifungal
treatment rather than stopping the antibiotic independently. Prompt treatment can
relieve the symptoms and prevent worsening discomfort.
,3. NGN—The nurse is making rounds on a group of clients when one client
suddenly begins exhibiting symptoms of an acute asthma attack, including
wheezing and difficulty breathing. The nurse administers a prescribed PRN short-
acting beta-2 receptor agonist to provide rapid bronchodilation. Which client
responses should the nurse expect after administration? SATA
Correct answers: Rapid resolution of wheezing; Improved pulse oximetry
values.
Short-acting beta-2 agonists produce rapid relaxation of bronchial smooth muscle,
which improves airflow and decreases bronchospasm. As airway obstruction
improves, wheezing should decrease and oxygenation should improve, resulting in
better pulse oximetry readings. The nurse should continue to assess respiratory rate,
breath sounds, oxygen saturation, and the client's overall work of breathing.
4. A client prescribed atenolol has a blood pressure of 120/68 mmHg, sinus
bradycardia with a heart rate of 58 beats/minute, and a PR interval of 0.24
seconds. The client is being assessed before the scheduled dose, and the nurse
reviews the cardiac rhythm and vital signs before administering the medication.
Which action should the nurse take?
Correct answer: Give the medication as prescribed and continue to monitor
the client.
Atenolol is a beta-adrenergic blocker that decreases heart rate and blood pressure,
so mild bradycardia can occur during therapy. The client's blood pressure is within an
acceptable range, and the prescribed medication should be administered while the
nurse continues to monitor the heart rate, rhythm, blood pressure, and clinical
status. Any worsening bradycardia, symptomatic hypotension, or significant
conduction changes should be reported promptly.
, 5. The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II
receptor blocker, for a client with hypertension and heart failure. Before
administering the medication, the nurse reviews the client's laboratory results and
notes a serum potassium level of 5.9 mEq/L. Which action should the nurse take
first?
Correct answer: Withhold the scheduled dose.
Losartan can decrease aldosterone activity and reduce potassium excretion, which
can contribute to hyperkalemia. A potassium level of 5.9 mEq/L is significantly
elevated and places the client at risk for potentially serious cardiac dysrhythmias. The
nurse should withhold the scheduled dose and notify the healthcare provider so that
the elevated potassium level and medication regimen can be evaluated.
6. NGN—A client with acute status asthmaticus is prescribed a series of
medications to address bronchospasm, inflammation, and the underlying clinical
condition. The prescriptions include salmeterol (Serevent Diskus), albuterol
(Proventil) puffs, gentamicin (Garamycin) IM, and prednisone (Deltasone) orally.
The nurse must prioritize the medications according to the sequence provided in
the treatment plan. In which order should the nurse administer these medications?
Correct answer: 1) Albuterol (Proventil) → 2) Salmeterol (Serevent Diskus) → 3)
Prednisone (Deltasone) orally → 4) Gentamicin (Garamycin) IM.
Albuterol is administered first because it is a short-acting beta-2 agonist that
produces rapid bronchodilation and is used for acute bronchospasm. Prednisone
provides systemic anti-inflammatory effects that help decrease airway inflammation,
while gentamicin is administered when treatment of a susceptible bacterial infection
is indicated. The sequence prioritizes rapid improvement of bronchospasm before
therapies directed toward inflammation or an infectious cause.
